Amedisys Reports Fourth Quarter and Year-End 2023 Financial Results


BATON ROUGE, La., Feb. 21, 2024 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three-month period and year ended December 31, 2023.

Three-Month Periods Ended December 31, 2023 and 2022

  • Net service revenue increased $8.8 million to $570.8 million compared to $562.0 million in 2022. Prior year included $15.9 million of net service revenue from our personal care business which was divested on March 31, 2023.
  • Net income attributable to Amedisys, Inc. of $19.3 million, which is inclusive of $11.5 million in costs associated with with our merger transactions, compared to $31.7 million in 2022.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.59 compared to $0.97 in 2022.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $56.7 million compared to $59.9 million in 2022.
  • Adjusted net service revenue of $570.8 million compared to $562.0 million in 2022. Prior year included $15.9 million of net service revenue from our personal care business which was divested on March 31, 2023.
  • Adjusted net income attributable to Amedisys, Inc. of $30.8 million compared to $38.0 million in 2022.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $0.94 compared to $1.16 in 2022.

Years Ended December 31, 2023 and 2022

  • Net service revenue increased $13.2 million to $2,236.4 million compared to $2,223.2 million in 2022. Prior year included $61.4 million of net service revenue from our personal care business which was divested on March 31, 2023 compared to $15.0 million in 2023.
  • Net loss attributable to Amedisys, Inc. of $9.7 million, which is inclusive of $142.7 million in costs associated with our merger transactions, compared to net income attributable to Amedisys, Inc. of $118.6 million in 2022.
  • Net loss attributable to Amedisys, Inc. per diluted share of $0.30 compared to net income attributable to Amedisys, Inc. per diluted share of $3.63 in 2022.

Adjusted Year End Results*

  • Adjusted EBITDA of $247.0 million compared to $262.1 million in 2022.
  • Adjusted net service revenue of $2,236.4 million compared to $2,232.5 million in 2022. Prior year included $61.4 million of net service revenue from our personal care business which was divested on March 31, 2023 compared to $15.0 million in 2023.
  • Adjusted net income attributable to Amedisys, Inc. of $140.6 million compared to $163.4 million in 2022.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $4.30 compared to $5.01 in 2022.

* See pages 2 and 14-16 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

The supplemental slides provided in connection with the fourth quarter and year ended December 31, 2023 earnings release can be found on the Investor Relations page of our website. In light of the pending merger of the Company with UnitedHealth Group Incorporated, Amedisys will not conduct a quarterly earnings call to discuss the fourth quarter and year ended December 31, 2023 results.

Non-GAAP Financial Measures

This press release includes reconciliations of the most comparable financial measures calculated and presented in accordance with accounting principles generally accepted in the U.S. (“GAAP”) to non-GAAP financial measures. The non-GAAP financial measures as defined under SEC rules are as follows: (1) adjusted EBITDA, defined as net income (loss) attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items; (2) adjusted net service revenue, defined as net service revenue excluding certain items; (3) adjusted net income attributable to Amedisys, Inc., defined as net income (loss) attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items; and (4) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income (loss) attributable to Amedisys, Inc. common stockholders per diluted share calculated in accordance with GAAP excluding certain items. Management believes that these non-GAAP financial measures, when reviewed in conjunction with GAAP financial measures, are useful gauges of our current performance and are also included in internal management reporting. These non-GAAP financial measures should be considered in addition to, and not more meaningful than or as an alternative to the GAAP financial measures presented in this earnings release and the company’s financial statements. Non-GAAP measures as presented herein may not be comparable to similarly titled measures reported by other companies since not all companies calculate these non-GAAP measures consistently.

Additional information

Amedisys, Inc. (the “Company”) is a leading healthcare at home company delivering personalized home health, hospice and high acuity care services. Amedisys is focused on delivering the care that is best for our patients, whether that is in-patient hospital, palliative and skilled nursing facility ("SNF") care in their homes, home-based recovery and rehabilitation after an operation or injury, care focused on empowering our patients to manage a chronic disease or hospice care at the end of life. More than 3,000 hospitals and 110,000 physicians nationwide have chosen Amedisys as a partner in post-acute care. Founded in 1982, headquartered in Baton Rouge, LA with an executive office in Nashville, TN, Amedisys is a publicly held company. With approximately 19,000 employees in 521 care centers within 37 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 469,000 patients every year. For more information about the Company, please visit: www.amedisys.com.

We use our website as a channel of distribution for important company information. Important information, including press releases, investor presentations and financial information regarding our company, is routinely posted on and accessible on the Investor Relations subpage of our website, which is accessible by clicking on the tab labeled “Investors” on our website home page. Visitors to our website can also register to receive automatic e-mail and other notifications alerting them when new information is made available on the Investor Relations subpage of our website.

Forward-Looking Statements

When included in this press release, words like “believes,” “belief,” “expects,” “strategy,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “could,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: disruption from the proposed merger with UnitedHealth Group with patient, payor, provider, referral source, supplier or management and employee relationships; the occurrence of any event, change or other circumstances that could give rise to the termination of the merger agreement with UnitedHealth Group or the inability to complete the proposed transaction on the anticipated terms and timetable; the risk that necessary regulatory approvals for the proposed merger with UnitedHealth Group are delayed, are not obtained or are obtained subject to conditions that are not anticipated; the failure of the conditions to the proposed merger to be satisfied; the costs related to the proposed transaction; the diversion of management time on merger-related issues; the risk that termination fees may be payable by the Company in the event that the merger agreement is terminated under certain circumstances; reputational risk related to the proposed merger; the risk of litigation or regulatory action related to the proposed merger; changes in Medicare and other medical payment levels; changes in payments and covered services by federal and state governments; future cost containment initiatives undertaken by third-party payors; changes in the episodic versus non-episodic mix of our payors, the case mix of our patients and payment methodologies; staffing shortages driven by the competitive labor market; our ability to attract and retain qualified personnel; competition in the healthcare industry; our ability to maintain or establish new patient referral sources; changes in or our failure to comply with existing federal and state laws or regulations or the inability to comply with new government regulations on a timely basis; changes in estimates and judgments associated with critical accounting policies; our ability to consistently provide high-quality care; our ability to keep our patients and employees safe; our access to financing; our ability to meet debt service requirements and comply with covenants in debt agreements; business disruptions due to natural or man-made disasters, climate change or acts of terrorism, widespread protests or civil unrest; our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively; our ability to realize the anticipated benefits of acquisitions, investments and joint ventures; our ability to integrate, manage and keep our information systems secure; the impact of inflation; and changes in laws or developments with respect to any litigation relating to the Company, including various other matters, many of which are beyond our control.

Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, you should not rely on any forward-looking statement as a prediction of future events. We expressly disclaim any obligation or undertaking and we do not intend to release publicly any updates or changes in our expectations concerning the forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based, except as required by law.

Contact: Investor Contact:Media Contact:
 Amedisys, Inc.Amedisys, Inc.
 Nick MuscatoKendra Kimmons
 Chief Strategy OfficerVice President, Marketing & Communications
 (615) 928-5452(225) 299-3720
 IR@amedisys.com kendra.kimmons@amedisys.com



AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
 
 For the Three-Month 
Periods Ended December 31,
 For the Years Ended
December 31,
  2023   2022   2023   2022 
 (Unaudited)    
Net service revenue$570,788  $562,064  $2,236,382  $2,223,199 
Operating expenses:       
Cost of service, inclusive of depreciation 321,416   317,167   1,245,509   1,260,425 
General and administrative expenses:       
Salaries and benefits 140,603   132,003   521,529   508,791 
Non-cash compensation 7,114   570   26,082   16,560 
Merger-related expenses 11,521      36,672    
Depreciation and amortization 4,143   5,230   17,747   24,935 
Investment impairment          3,009 
Other 51,982   60,856   232,449   228,707 
Total operating expenses 536,779   515,826   2,079,988   2,042,427 
Operating income 34,009   46,238   156,394   180,772 
Other income (expense):       
Interest income 818   70   3,270   178 
Interest expense (8,234)  (5,781)  (31,274)  (22,228)
Equity in earnings (loss) from equity method investments 1,394   397   10,760   (45)
Merger termination fee       (106,000)   
Miscellaneous, net 1,211   412   6,473   1,567 
Total other expense, net (4,811)  (4,902)  (116,771)  (20,528)
Income before income taxes 29,198   41,336   39,623   160,244 
Income tax expense (10,178)  (9,790)  (50,559)  (42,545)
Net income (loss) 19,020   31,546   (10,936)  117,699 
Net loss attributable to noncontrolling interests 302   171   1,189   910 
Net income (loss) attributable to Amedisys, Inc.$19,322  $31,717  $(9,747) $118,609 
Basic earnings per common share:       
Net income (loss) attributable to Amedisys, Inc. common stockholders$0.59  $0.98  $(0.30) $3.65 
Weighted average shares outstanding 32,635   32,511   32,599   32,517 
Diluted earnings per common share:       
Net income (loss) attributable to Amedisys, Inc. common stockholders$0.59  $0.97  $(0.30) $3.63 
Weighted average shares outstanding 32,913   32,602   32,599   32,653 



AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)
 
 As of December 31,
  2023   2022 
ASSETS   
Current assets:   
Cash and cash equivalents$126,450  $40,540 
Restricted cash 12,413   13,593 
Patient accounts receivable 313,373   296,785 
Prepaid expenses 14,639   11,628 
Other current assets 30,060   26,415 
Total current assets 496,935   388,961 
Property and equipment, net of accumulated depreciation of $92,422 and $101,364 41,845   16,026 
Operating lease right of use assets 88,939   102,856 
Goodwill 1,244,679   1,287,399 
Intangible assets, net of accumulated amortization of $14,008 and $14,604 102,675   101,167 
Other assets 85,097   79,836 
Total assets$2,060,170  $1,976,245 
LIABILITIES AND EQUITY   
Current liabilities:   
Accounts payable$28,237  $43,735 
Payroll and employee benefits 136,835   125,387 
Accrued expenses 140,049   137,390 
Termination fee paid by UnitedHealth Group 106,000    
Current portion of long-term obligations 36,314   15,496 
Current portion of operating lease liabilities 26,286   33,521 
Total current liabilities 473,721   355,529 
Long-term obligations, less current portion 361,862   419,420 
Operating lease liabilities, less current portion 62,751   69,504 
Deferred income tax liabilities 40,635   20,411 
Other long-term obligations 1,418   4,808 
Total liabilities 940,387   869,672 
Equity:   
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding     
Common stock, $0.001 par value, 60,000,000 shares authorized; 38,131,478 and 37,891,186 shares issued; and 32,667,631 and 32,511,465 shares outstanding 38   38 
Additional paid-in capital 787,177   755,063 
Treasury stock at cost, 5,463,847 and 5,379,721 shares of common stock (468,626)  (461,200)
Retained earnings 747,925   757,672 
Total Amedisys, Inc. stockholders’ equity 1,066,514   1,051,573 
Noncontrolling interests 53,269   55,000 
Total equity 1,119,783   1,106,573 
Total liabilities and equity$2,060,170  $1,976,245 



AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
 
 For the Three-Month 
Periods Ended December 31,
 For the Years Ended
December 31,
  2023   2022   2023   2022 
 (Unaudited)    
Cash Flows from Operating Activities:       
Net income (loss)$19,020  $31,546  $(10,936) $117,699 
Adjustments to reconcile net income (loss) to net cash provided by operating activities:       
Depreciation and amortization (inclusive of depreciation included in cost of service) 5,891   5,230   23,847   24,935 
Non-cash compensation 9,400   570   29,024   16,560 
Amortization and impairment of operating lease right of use assets 8,569   11,247   33,996   46,029 
(Gain) loss on disposal of property and equipment (27)  12   319   519 
Deferred income taxes 5,238   4,346   20,655   23,377 
Loss on personal care divestiture       2,186    
Merger termination fee       106,000    
Equity in (earnings) loss from equity method investments (1,394)  (397)  (10,760)  45 
Amortization of deferred debt issuance costs 248   248   991   991 
Return on equity method investments 764   1,365   5,073   5,163 
Investment impairment          3,009 
Changes in operating assets and liabilities, net of impact of acquisitions:       
Patient accounts receivable 6,207   4,036   (26,727)  (14,230)
Other current assets 8,796   16,404   (6,638)  (3,525)
Operating lease right of use assets (983)  (919)  (3,786)  (3,242)
Other assets (84)  155   189   438 
Accounts payable (6,977)  (992)  (15,816)  4,894 
Accrued expenses 13,354   (12,592)  23,694   (39,382)
Other long-term obligations (234)  (9,065)  (3,390)  (8,822)
Operating lease liabilities (7,477)  (10,311)  (30,733)  (41,175)
Net cash provided by operating activities 60,311   40,883   137,188   133,283 
Cash Flows from Investing Activities:       
Proceeds from the sale of deferred compensation plan assets 29   163   54   252 
Proceeds from the sale of property and equipment 36      136   66 
Purchases of property and equipment (1,892)  (1,827)  (5,620)  (6,165)
Investments in technology assets (212)  (202)  (7,093)  (1,050)
Investment in equity method investee          (637)
Purchase of cost method investment          (15,000)
Return of investment       150    
Proceeds from personal care divestiture       47,787    
Acquisitions of businesses, net of cash acquired       (350)  (71,952)
Net cash (used in) provided by investing activities (2,039)  (1,866)  35,064   (94,486)
Cash Flows from Financing Activities:       
Proceeds from issuance of stock upon exercise of stock options    1,226   100   2,304 
Proceeds from issuance of stock to employee stock purchase plan    991   2,602   3,848 
Shares withheld to pay taxes on non-cash compensation (2,116)  (32)  (6,529)  (7,981)
Noncontrolling interest contributions 220   1,401   1,452   3,501 
Noncontrolling interest distributions (259)  (136)  (1,873)  (1,561)
Proceeds from sale of noncontrolling interest    1,876      5,817 
Purchase of noncontrolling interest       (800)   
Proceeds from borrowings under revolving line of credit    50,500   23,000   534,500 
Repayments of borrowings under revolving line of credit    (69,000)  (23,000)  (534,500)
Principal payments of long-term obligations (8,900)  (3,170)  (76,013)  (13,296)
Purchase of company stock          (17,351)
Payment of accrued contingent consideration (2,370)     (6,461)  (5,714)
Net cash used in financing activities (13,425)  (16,344)  (87,522)  (30,433)
Net increase in cash, cash equivalents and restricted cash 44,847   22,673   84,730   8,364 
Cash, cash equivalents and restricted cash at beginning of period 94,016   31,460   54,133   45,769 
Cash, cash equivalents and restricted cash at end of period$138,863  $54,133  $138,863  $54,133 
        
 For the Three-Month 
Periods Ended December 31,
 For the Years Ended
December 31,
  2023   2022   2023   2022 
 (Unaudited)    
Supplemental Disclosures of Cash Flow Information:       
Cash paid for interest$7,888  $5,786  $29,766  $14,939 
Cash paid for Infinity ZPIC interest$  $1,211  $  $12,755 
Cash paid for income taxes, net of refunds received$4,809  $431  $29,127  $24,013 
Supplemental Disclosures of Non-Cash Activity:       
Accrued contingent consideration$  $  $  $19,195 
Noncontrolling interest contribution$  $  $  $8,900 
Days revenue outstanding (1) 47.7   46.1   47.7   46.1 

(1) Our calculation of days revenue outstanding at December 31, 2023 and 2022 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three-month periods ended December 31, 2023 and 2022, respectively.


AMEDISYS, INC. AND SUBSIDIARIES
SEGMENT INFORMATION
(Amounts in millions, except statistical information)
(Unaudited)

Segment Information - Home Health

 For the Three-Month Periods
Ended December 31,
  2023   2022 
Financial Information (in millions)(6):   
Medicare$221.1  $224.8 
Non-Medicare 137.8   120.1 
Net service revenue 358.9   344.9 
Cost of service, inclusive of depreciation 208.0   197.3 
Gross margin 150.9   147.6 
General and administrative expenses 92.8   90.0 
Depreciation and amortization 1.9   0.7 
Operating income$56.2  $56.9 
Same Store Growth(1):   
Medicare revenue (1%)  (6%)
Non-Medicare revenue 15%  8%
Total admissions 7%  5%
Total volume(2) 5%  1%
Key Statistical Data - Total(3)(6):   
Admissions 101,809   95,006 
Recertifications 44,893   44,670 
Total volume 146,702   139,676 
    
Medicare completed episodes 73,892   76,357 
Average Medicare revenue per completed episode(4)$2,997  $2,995 
Medicare visits per completed episode(5) 12.2   12.6 
    
Visiting clinician cost per visit$108.64  $104.12 
Clinical manager cost per visit 12.12   11.77 
Total cost per visit$120.76  $115.89 
Visits 1,721,985   1,702,334 


 For the Years Ended
December 31,
  2023   2022 
Financial Information (in millions)(6):   
Medicare$874.2  $896.5 
Non-Medicare 529.4   465.2 
Net service revenue 1,403.6   1,361.7 
Cost of service, inclusive of depreciation 801.1   773.9 
Gross margin 602.5   587.8 
General and administrative expenses 363.5   351.1 
Depreciation and amortization 6.0   4.0 
Operating income$233.0  $232.7 
Same Store Growth(1):   
Medicare revenue (3%)  (5%)
Non-Medicare revenue 13%  2%
Total admissions 6%  3%
Total volume(2) 4%  %
Key Statistical Data - Total(3)(6):   
Admissions 399,752   376,399 
Recertifications 179,719   178,445 
Total volume 579,471   554,844 
    
Medicare completed episodes 295,017   305,455 
Average Medicare revenue per completed episode(4)$2,998  $3,013 
Medicare visits per completed episode(5) 12.4   12.9 
    
Visiting clinician cost per visit$103.31  $100.03 
Clinical manager cost per visit 11.58   11.19 
Total cost per visit$114.89  $111.22 
Visits 6,972,929   6,958,541 

(1) Same store information represents the percent change in our Medicare, Non-Medicare and Total revenue, admissions or volume for the period as a percent of the Medicare, Non-Medicare and Total revenue, admissions or volume of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total volume includes all admissions and recertifications.
(3) Total includes acquisitions, start-ups and de novos.
(4) Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care. Average Medicare revenue per completed episode reflects the suspension of sequestration for the period May 1, 2020 through March 31, 2022 and the reinstatement of sequestration at 1% effective April 1, 2022 and at 2% effective July 1, 2022.
(5) Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.
(6) Prior year has been recast to conform to the current year presentation.

Segment Information - Hospice

 For the Three-Month Periods
Ended December 31,
  2023   2022 
Financial Information (in millions):   
Medicare$194.2  $186.3 
Non-Medicare 11.8   11.3 
Net service revenue 206.0   197.6 
Cost of service, inclusive of depreciation 107.8   103.3 
Gross margin 98.2   94.3 
General and administrative expenses 48.9   51.3 
Depreciation and amortization 0.9   0.6 
Operating income$48.4  $42.4 
Same Store Growth(1):   
Medicare revenue 4%  (4%)
Hospice admissions (3%)  (8%)
Average daily census %  (2%)
Key Statistical Data - Total(2):   
Hospice admissions 12,226   12,629 
Average daily census 12,859   12,878 
Revenue per day, net$174.10  $166.82 
Cost of service per day$91.18  $87.21 
Average discharge length of stay 97   94 


 For the Years Ended
December 31,
  2023   2022 
Financial Information (in millions):   
Medicare$754.0  $744.1 
Non-Medicare 44.8   43.7 
Net service revenue 798.8   787.8 
Cost of service, inclusive of depreciation 412.2   426.5 
Gross margin 386.6   361.3 
General and administrative expenses 193.1   203.3 
Depreciation and amortization 3.0   2.3 
Operating income$190.5  $155.7 
Same Store Growth(1):   
Medicare revenue 1%  (1%)
Hospice admissions (5%)  (1%)
Average daily census (1%)  (1%)
Key Statistical Data - Total(2):   
Hospice admissions 49,587   52,656 
Average daily census 12,863   13,091 
Revenue per day, net$170.14  $164.88 
Cost of service per day$87.80  $89.26 
Average discharge length of stay 93   91 

(1) Same store information represents the percent change in our Medicare revenue, Hospice admissions or average daily census for the period as a percent of the Medicare revenue, Hospice admissions or average daily census of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total includes acquisitions and de novos.

Segment Information - Personal Care(1)

 For the Three-Month Periods
Ended December 31,
  2023  2022
Financial Information (in millions):   
Medicare$ $
Non-Medicare   15.9
Net service revenue   15.9
Cost of service, inclusive of depreciation   12.3
Gross margin   3.6
General and administrative expenses   2.3
Depreciation and amortization   
Operating income$ $1.3
Key Statistical Data - Total:   
Billable hours   453,644
Clients served   7,720
Shifts   193,220
Revenue per hour$ $35.07
Revenue per shift$ $82.34
Hours per shift   2.3


 For the Years Ended
December 31,
  2023  2022
Financial Information (in millions):   
Medicare$ $
Non-Medicare 15.0  61.4
Net service revenue 15.0  61.4
Cost of service, inclusive of depreciation 11.1  46.7
Gross margin 3.9  14.7
General and administrative expenses 2.3  9.2
Depreciation and amortization   0.1
Operating income$1.6 $5.4
Key Statistical Data - Total:   
Billable hours 440,464  1,851,563
Clients served 7,892  10,448
Shifts 191,379  791,596
Revenue per hour$33.97 $33.15
Revenue per shift$78.19 $77.55
Hours per shift 2.3  2.3

(1)    We completed the sale of our personal care business on March 31, 2023.

Segment Information - High Acuity Care

 For the Three-Month Periods
Ended December 31,
  2023   2022 
Financial Information (in millions)(1):   
Medicare$  $ 
Non-Medicare 5.9   3.6 
Net service revenue 5.9   3.6 
Cost of service, inclusive of depreciation 5.6   4.3 
Gross margin 0.3   (0.7)
General and administrative expenses 5.4   5.0 
Depreciation and amortization 0.8   0.9 
Operating loss$(5.9) $(6.6)
Key Statistical Data - Total:   
Full risk admissions 105   108 
Limited risk admissions 600   374 
Total admissions 705   482 
    
Full risk revenue per episode$10,919  $12,282 
Limited risk revenue per episode$6,901  $5,545 
    
Number of admitting joint ventures 10   8 


 For the Years Ended December 31,
  2023   2022 
Financial Information (in millions)(1):   
Medicare$  $ 
Non-Medicare 19.0   12.3 
Net service revenue 19.0   12.3 
Cost of service, inclusive of depreciation 21.1   13.3 
Gross margin (2.1)  (1.0)
General and administrative expenses 20.4   19.7 
Depreciation and amortization 3.1   3.3 
Investment impairment    3.0 
Operating loss$(25.6) $(27.0)
Key Statistical Data - Total:   
Full risk admissions 648   448 
Limited risk admissions 1,804   1,142 
Total admissions 2,452   1,590 
    
Full risk revenue per episode$10,565  $11,273 
Limited risk revenue per episode$6,187  $5,553 
    
Number of admitting joint ventures 10   8 

(1)    Prior year has been recast to conform to the current year presentation.

Segment Information - Corporate

 For the Three-Month Periods
Ended December 31,
  2023  2022
Financial Information (in millions)(1):   
General and administrative expenses$64.1 $44.7
Depreciation and amortization 0.6  3.0
Total operating expenses$64.7 $47.7


 For the Years Ended
December 31,
  2023  2022
Financial Information (in millions)(1):   
General and administrative expenses$237.5 $170.8
Depreciation and amortization 5.6  15.2
Total operating expenses$243.1 $186.0

(1)    Prior year has been recast to conform to the current year presentation.

  

AMEDISYS, INC. AND SUBSIDIARIES
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES TO GAAP MEASURES
(Amounts in thousands)
(Unaudited)

Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization ("Adjusted EBITDA") Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2023  2022  2023   2022 
Net income (loss) attributable to Amedisys, Inc.$19,322 $31,717 $(9,747) $118,609 
Add:       
Income tax expense 10,178  9,790  50,559   42,545 
Interest expense, net 7,416  5,711  28,004   22,050 
Depreciation and amortization 5,891  5,230  23,847   24,935 
Certain items(1) 13,846  7,441  154,344   58,361 
Interest component of certain items(1)        (4,445)
Adjusted EBITDA(2)(6)$56,653 $59,889 $247,007  $262,055 


Adjusted Net Service Revenue Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2023  2022  2023  2022
Net service revenue$570,788 $562,064 $2,236,382 $2,223,199
Add:       
Certain items(1)       9,305
Adjusted net service revenue(3)(6)$570,788 $562,064 $2,236,382 $2,232,504


Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2023  2022  2023   2022
Net income (loss) attributable to Amedisys, Inc.$19,322 $31,717 $(9,747) $118,609
Add:       
Certain items(1) 11,500  6,251  150,384   44,838
Adjusted net income attributable to Amedisys, Inc.(4)(6)$30,822 $37,968 $140,637  $163,447


Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2023  2022  2023   2022
Net income (loss) attributable to Amedisys, Inc. common stockholders per diluted share$0.59 $0.97 $(0.30) $3.63
Add:       
Certain items(1) 0.35  0.19  4.60   1.37
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share(5)(6)$0.94 $1.16 $4.30  $5.01


(1) The following details the certain items for the three-month periods and years ended December 31, 2023 and 2022:

Certain Items:

 For the Three-Month Period
Ended December 31, 2023
 For the Year Ended
December 31, 2023
 (Income) Expense (Income) Expense
Certain Items Impacting Cost of Service, Inclusive of Depreciation:   
Clinical optimization and reorganization costs 199   595
Certain Items Impacting General and Administrative Expenses:   
Acquisition and integration costs 180   3,286
CEO transition 661   5,940
Merger-related expenses 11,521   36,672
Clinical optimization and reorganization costs 1,819   6,022
Personal care divestiture    525
Certain Items Impacting Total Other Income (Expense):   
Other (income) expense, net* (534)  101,304
Total$13,846  $154,344
Net of tax$11,500  $150,384
Diluted EPS$0.35  $4.60

*Includes $106,000 merger termination fee for the year ended December 31, 2023

 For the Three-Month Period
Ended December 31, 2022
 For the Year Ended
December 31, 2022
 (Income) Expense (Income) Expense
Certain Items Impacting Net Service Revenue:   
Contingency accrual$ $9,305 
Certain Items Impacting Cost of Service:   
COVID-19 costs 1,510  8,747 
Clinical optimization and reorganization costs 33  1,382 
Fuel supplement 261  3,576 
Integration costs   1,712 
Certain Items Impacting General and Administrative Expenses:   
Acquisition and integration costs 1,443  11,298 
COVID-19 costs 107  503 
CEO transition   3,500 
Severance 993  993 
Legal fees - non-routine   241 
Clinical optimization and reorganization costs 2,247  5,792 
Legal settlement   (1,058)
Fuel supplement 33  251 
Investment impairment   3,009 
Certain Items Impacting Total Other Income (Expense):   
Interest component of certain items   4,445 
Other expense, net 814  4,665 
Total$7,441 $58,361 
Net of tax$6,251 $44,838 
Diluted EPS$0.19 $1.37 

(2) Adjusted EBITDA is defined as net income (loss) attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items as described in footnote 1.
(3) Adjusted net service revenue is defined as net service revenue excluding certain items as described in footnote 1.
(4) Adjusted net income attributable to Amedisys, Inc. is defined as net income (loss) attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items as described in footnote 1.
(5) Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share is defined as diluted income (loss) per share calculated in accordance with GAAP excluding the earnings per share effect of certain items as described in footnote 1.
(6) Adjusted EBITDA, adjusted net service revenue, adjusted net income attributable to Amedisys, Inc. and adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share should not be considered as an alternative to, or more meaningful than, income before income taxes or other measures calculated in accordance with GAAP. These calculations may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate these non-GAAP financial measures in the same manner.